- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical...Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- UPMC (Pittsburgh, PA)
- …Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , Utilization Management ... UPMC Health Plan members. They will oversee adherence to quality and utilization standards through committee delegations and further establish an effective working… more
- Wellpath (Lemoyne, PA)
- …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review, ... efforts to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key… more
- LifeCenter Northwest (Bellevue, WA)
- …- $199,200.00 Salary Position Type Full Time Description and Qualifications The Director , Organ Utilization ( Director ), is responsible for overseeing ... of organ donation systems, allocation practices, and regulatory compliance. The Director develops and executes strategies to improve organ allocation strategy and… more
- UNC Health Care (Morrisville, NC)
- …well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and operational ... leader responsible for designing, implementing, and standardizing utilization management functions across a large healthcare system, including a complex academic… more
- Fallon Health (Worcester, MA)
- … Director to identify and prioritize the cost of care opportunities related to Utilization Management. + Works with VP/ Medical Director to set agenda related ... of purpose:** With the general direction from the VP Sr. Medical Director Clinical Management and SVP/Chief Medical Officer will provide strategic leadership and… more
- Healthfirst (NY)
- …maintain and improve department performance** + **Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement** + ... Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to align utilization decisions** + **Partner with technology and data teams to refine data… more
- Integra Partners (Troy, MI)
- …operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of criteria, ... Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director 's responsibilities include but are not… more
- Integra Partners (Troy, MI)
- The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support ... and are committed to consistency, compliance, and evidence-based decision making. The Utilization Review Medical Director 's responsibilities include but are not… more
- Elevance Health (Indianapolis, IN)
- ** Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... by law. Alternate locations may be considered. The **Medical Director ** is responsible for reviewing cases for IN Medicaid...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more